Videoconference-delivered Mind-Body Resiliency Training in Adults with congenital heart disease: A pilot feasibility trial
Christina M. Luberto, Amy Wang, Runnan Li, Jaclyn Pagliaro, Elyse R. Park, Ami Bhatt
Abstract
Adults with congenital heart disease (ACHD) often experience elevated health anxiety. The SMART-3RP is an eight-week, mind-body group resiliency intervention with evidence to reduce health anxiety in other medical populations. The aims of this waitlist-controlled, randomized pilot feasibility trial were to explore (1) feasibility and acceptability of videoconference-delivered SMART-3RP, (2) feasibility and acceptability of remote blood pressure monitoring, and (3) changes in health anxiety, mindfulness, and resiliency. Participants (N = 12 adults with CHD; Mean age = 41.2 years, SD = 13.8, 100% white, and 75% female) were 1:1 randomized into a pilot from July 2020 to September 2020. Participants completed surveys at baseline, three-month, and six-month follow-up; recorded their blood pressure via a digital health platform four times per week for eight weeks post-randomization (n = 32 total recordings); and completed individual exit interviews. 91% (29/32) of patients screened were eligible; of those, 41% (12/29) enrolled. 83% were retained at three-month follow-up (10/12) and 90% of those (9/10) were retained at six months. Average adherence to blood pressure monitoring was 70% (22/32 recordings completed; SD = 31.9). Effect sizes from baseline to three months suggested greater improvement in the immediate group compared to the waitlist group for health anxiety (Cohen's r = −.59), mindfulness (r = −0.44), and resiliency (r = −0.49). Exit interviews revealed positive experiences with the intervention, benefits of mindfulness skills for coping with anxiety, and suggestions for improvement including further targeting ACHD-specific needs. These findings support the feasibility of conducting a randomized controlled efficacy trial of SMART-3RP for ACHD, and the acceptability and potential utility of SMART-3RP for emotional health in ACHD.